The Legal Guardian

$117M crash lawsuit: A dose of reality

If you are the manager, supervisor or training officer of a provider or agency who doesn't think it's important to follow up on issues of substandard performance, please allow me to administer this high dose of reality.

Last month, a jury awarded $117 million to a woman who was severely hurt while riding in an ambulance that crashed into the back of a truck. To put it into perspective, at roughly $15 per hour, that's 7,800,000 hours pay — before taxes.

The patient, 21 years old and seven months pregnant, was complaining of abdominal pains and called an ambulance to take her for evaluation. The ambulance arrived, and the patient was transported, non-emergency, to the hospital.

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En route, however, the ambulance rear-ended a truck, and the patient was critically injured.

The patient's injuries included a severed spinal cord and a traumatic brain injury. She is left with only limited use of one arm and will continue to be treated in and out of a variety of hospitals for the rest of her life.

The accident also caused the woman to give birth prematurely. Thankfully, the baby survived, despite a birth weight of barely 3 pounds.

At trial, the woman's attorney argued negligence and recklessness. He showed that the ambulance was traveling upward of 60 mph and not using the emergency lights or siren.

According to trial testimony, it seems that the driver took his attention off the road and reached to retrieve a GPS unit that had fallen to the floor.

If we stop the story right here, this is a terrible accident but, while tragic, does not warrant the kind of harsh message that a $117M award sends to the industry. But there's more.

Other facts came to light at the trial, such as the driver's prior accidents and his 30 months of consistent failure to meet minimum driving standards. The agency knew about the deficiencies and failed to fix them.

The agency knew about the deficiencies... and failed to fix them.

I was not there, and I have no opinion about what did or didn't happen, but I do know that sweeping issues under the rug is common to the point of being cultural in far too many EMS agencies, particularly in the private sector.

I know that issues such as nepotism, favoritism and internal politics have plenty to do with much of what prevents EMS from finally emerging as a profession rather than just a job.

However, the one thing I have never understood is how anyone who claims to be an EMS provider can stand by and overlook critical training deficiencies. How does anyone in EMS ignore 30 months of consistent failure to meet minimum standards?

A quick read of the story might suggest that the simple $117M lesson here is "Drive safely." That would be incorrect.

The plaintiff's attorney summed up the real lesson: "We trust ambulances to take us to safety, not put us in greater danger."

It doesn't matter what uniform the provider wears, what color the ambulance is painted or who pays the bills; providers change, agencies change, service areas change, and it doesn't really matter because none of those things are the real currency of EMS.

The only real currency EMS has is public trust. When the public trust is spent, it is extraordinarily difficult to recoup.

Maybe it's easy for supervisors, managers and training officers to lose sight of that because they spend more time behind desks than they do on the street without looking the public in the face multiple times each day; I can't say for sure.

But I do know that they are every bit as responsible for maintaining that public trust as anyone else.

When citizens call 911 for EMS, they want help to come now because they are in some kind of immediate trouble.

But with that same call, they are depending on the managers to have cultivated the right environment for providers to thrive.

They are depending on the training officers to have made sure that whoever arrives knows what they are doing all the way through.

And they are depending on the supervisors to ensure that every responder does what's right.

Indeed, there may be two providers on an ambulance, but there is a team of equally important and accountable individuals behind them, and they all share in the responsibility of providing EMS.

There is no doubt that the driver in this case is the actual cause; but for his failure to stop, the patient would not have suffered those injuries as, how and when she did.

However, he is not alone. The individuals within the agency responsible for training and discipline and supervision are and should be held equally liable.

A single provider does not an EMS system make. The public may see EMS as the sum of its parts, but EMS is only and will only ever be as good as the weakest, laziest, most complacent and dumbest members.

About the author

David Givot, Esq., graduated from the UCLA Center for Prehospital Care (formerly DFH) in June 1989 and spent most of the next decade working as a Paramedic responding to 911 in Glendale, CA, with the (then BLS only) fire department. By the end of 1998, he was traveling around the country working with distressed EMS agencies teaching improved field provider performance through better communication and leadership practices. David then moved into the position of director of operations for the largest ambulance provider in the Maryland. Now, back in Los Angeles, he has earned his law degree and is a practicing Defense Attorney still looking to the future of EMS. In addition to defending EMS Providers, both on the job and off, he has created TheLegalGuardian.com as a vital step toward improving the state of EMS through information and education designed to protect EMS professionals - and agencies - nationwide. David is a member of the EMS1 Editorial Advisory Board. David can be contacted via e-mail at david.givot@ems1.com.

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